By Susan Finley, Ed.D., NCC
There are many misconceptions regarding the detention of mentally disordered people for evaluation and treatment. This article will help to explain the ins and outs of a 5150 Article 1 psychiatric hold under the state of California. In addition, differing facilities and health insurance policies may have different procedures. Therefore, getting help for yourself or another person with serious mental health concerns is essential.
5150 ARTICLE 1. Detention of Mentally Disordered Persons for Evaluation and Treatment
When a person, as a result of a mental health disorder, is (a) in danger to others, (b) themselves, or (c) gravely disabled, a professional person designated by the county may, upon probable cause, take the person into custody for 72 hours. This is commonly referred to as “5150,” or the Detention of Mentally Disordered Persons for Evaluation and Treatment.
Going to the Facility
The person may request to be evaluated or treated at a facility by a mental health professional of their choice. However, the county cannot guarantee the facility or mental health professional is chosen will be available, but they will honor the person’s choice if able. For involuntary admission, the person may or may not be restrained in transit to the facility. For the person’s safety, transportation to the facility may be via ambulance. Suppose there are no beds available at the psychiatric facility. In that case, the person may be taken to a local ER, where they will be closely monitored until there is an opening at the facility.
Arrival at the Facility
The person will be held for up to 72 hours for assessment, evaluation, and crisis intervention. A staff member, if deemed appropriate, will be assigned to monitor the person for the first 12 hours in solitary confinement in the event they attempt to harm themselves or others. This means no doors in the bathroom, shower, etc. The first-night lights may be kept on, and a staff member may be assigned to be in the room while the person sleeps.
Risk Assessment
Upon admission, drawstrings, shoelaces, wire bras, and anything else that may be used for self-harm must be removed from the person’s clothing. A counselor of the same gender will search the person to ensure that they do not have anything hidden underneath their clothing. They will also check for marks or bruises on the person’s body. If taken into custody at their residence, the person shall also be provided the following information:
You may bring a few personal items, which I will have to approve. Please inform me if you need assistance turning off any appliances or water. You may make a phone call and leave a note to tell your friends or family where you have been taken. ”
The person may ask the facility before admittance what is allowed and what will be confiscated during their stay. If the person is involuntarily committed and has no packed clothing, additional garments (robes, socks, underwear) will be provided.
Intake
A thorough mental health evaluation will be taken upon arrival and before discharge. This involves an extensive profile of the person’s prior psychological history.
Vitals and Medication
Vitals are taken upon admission and checked regularly (every hour) for the first 12 hours, and the person’s physical and mental health are closely monitored throughout the 72 hours. During these 72 hours, the facility staff will evaluate the person and may be given treatment, including medications.
Personal Belongings
Purses, bags, wallets, or anything else in the person’s possession will be checked upon admission, held in the nurse’s station for safekeeping, and returned upon discharge. In addition, an inventory of all personal belongings (anything the person came in with) will be recorded so that the person can review that everything has been safely returned to them.
Amenities
Basic amenities will be provided to the person. These include food (regular meals), bedding, towels, soap, toothbrush, toothpaste, shampoo, comb, pads, or tampons. No razors for shaving or any sharp objects are permitted.
Outside communication and use of electronics
Cell phone or computer usage is prohibited. However, the person is given access to a payphone within the facility. Before confiscating personal belongings, people can get a list of numbers off their cellphones for use during their stay.
Day-to-Day Activities
Group and individual therapy throughout the person’s stay are expected. Activities to calm and promote interaction with other people include classes such as coping skills, self-care, craft making, snack breaks, smoke breaks, and TV usage. Activities are not mandatory but highly encouraged to promote maintaining a connection with others and deter isolation. Many people find that speaking with one another is a healing act. It is not uncommon for people to help one another get well by establishing a rapport and understanding.
Common Area/Sleeping Arrangement
Most facilities have common areas where books, magazines, board games, and cards are available for people to use. Depending on their condition, a person may be kept separate or share a room with up to six other people. Men and women may or may not be housed on the same floor. However, the sleeping area and bathroom are segregated by gender.
Discharge
After 72 hours, the person is ready for discharge. It is possible for the person to be released before the end of the 72 hours. But if the staff decides that they need continued treatment, the person can be held for a more extended time. If the person is held longer than 72 hours, they have the right to a lawyer, a qualified interpreter, and a hearing before a judge. If they cannot pay for a lawyer, then one will be provided to them free of charge. After the medical team of professionals deems the person safe for discharge, a treatment plan will be introduced, and regular follow-up with the person is standard.
Selected resources
California Legislative Information. ARTICLE 1. Detention of Mentally Disordered Persons for Evaluation and Treatment [5150–5155]
Susan Finley, Ed.D., NCC, is an educator, published researcher, and social media consultant for therapists. She is a National Certified Counselor (NCC), Board Certified-TeleMental Health Provider (BC-TMH), and Suicide Prevention Instructor (QPR) under the National Board for Certified Counselors.
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